PHYSICIANS DIALYSIS HACKETTSTOWN (NPI# 1588116701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588116701 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS DIALYSIS HACKETTSTOWN |
| Practice Address |
657 Willow Grove St Hackettstown NJ 07840-1868 |
| Mailing Address |
19559 Ne 10th Ave North Miami Beach FL 33179-3501 |
| Practice Telephone | 9084500396 |
| Mailing Telephone | 3056513261 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | GARY J BOOTH (CEO) |
| Authorized Official Telephone | 3056513261 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
23433 | NJ | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHYSICIANS DIALYSIS HACKETTSTOWN, LLC | 657 Willow Grove St, Suite 202, Hackettstown, NJ 07840-1868 |
| Street Address |
657 WILLOW GROVE ST |
| City | HACKETTSTOWN |
| State | NJ |
| Zip Code | 07840-1868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215937602 | Eric L Gross | Surgery | 657 Willow Grove St, Suite 302, Hackettstown, NJ 07840-1713 | 2005-07-28 |
| 1578994414 | Advocare, LLC | Surgery | 657 Willow Grove St, Suite 302, Hackettstown, NJ 07840-1868 | 2013-12-03 |
| 1427364850 | Jenna Tulane Stephens | Dietitian, Registered | 657 Willow Grove St, Suite 401, Hackettstown, NJ 07840-1868 | 2010-08-23 |
| 1528394921 | Mri Associates of Hackettstown LLC | Clinic/Center | 657 Willow Grove St, Suite 205, Hackettstown, NJ 07840-1868 | 2009-10-20 |
| 1275664906 | Eric L. Gross, Md, PC | Surgery | 657 Willow Grove St, Suite 302, Hackettstown, NJ 07840-1713 | 2007-03-07 |
| 1538231964 | Plaza Family Care PC | Pediatrics | 657 Willow Grove St, Suite 401, Hackettstown, NJ 07840-1713 | 2006-11-14 |
| 1942393863 | Renal Treatment Centers Northeast Inc | Clinic/Center | 657 Willow Grove St, West Wing Medical Plaza Ste 202, Hackettstown, NJ 07840-1713 | 2006-10-02 |
| 1629082300 | Jimmy Chang | Internal Medicine | 657 Willow Grove St, Suite 401, Hackettstown, NJ 07840-1868 | 2006-07-28 |
| 1770597551 | Adam Dick | Pediatrics | 657 Willow Grove St, Suite 401, Hackettstown, NJ 07840-1713 | 2006-07-28 |
| 1063426021 | Ann Falbo | Pediatrics | 657 Willow Grove St, Suite 401, Hackettstown, NJ 07840-1713 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740891894 | Amanda Kucevic | Assistant Behavior Analyst | 514 Moore Street, Hackettstown, NJ 07840 | 2020-08-12 |
| 1922571165 | Laura Montenegro | Social Worker | 3155 State Highway Route 10, Denville, NJ 07840 | 2019-01-10 |
| 1619447240 | Melissa Matturri | Pharmacist | 2045 Nj-57, Hackettstown, NJ 07840 | 2018-11-27 |
| 1164906806 | Best Choice Home Care Limited Liability Company | Home Health | 210a Goldfinch Court, Hackettstown, NJ 07840 | 2018-09-19 |
| 1003398405 | Qua Creative Kidz | Voluntary or Charitable | 707 Allen Rd, Hackettstown, NJ 07840 | 2018-08-31 |
| 1639669153 | Daniel A Jodexnis Jr. | Counselor | 112 East Ave Ste 9, Hackettstown, NJ 07840 | 2018-05-10 |
| 1649779489 | Advancing Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 Possum Dr., Apt. 1, Hackettstown, NJ 07840 | 2018-02-07 |
| 1902305717 | Advancing Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 185 Route 46 East, Apt. 1, Hackettstown, NJ 07840 | 2018-02-07 |
| 1538681473 | Sara Victoria Monk | Dietitian, Registered | 900 E Prospect Street, Hackettstown, NJ 07840 | 2017-07-12 |
| 1811426422 | Heather Mooneyhan | Nurse Practitioner | 57 U.S. 46, Suite #300, Hackettstown, NJ 07840 | 2017-06-07 |
| Find all providers in zip 07840 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942393863 | Renal Treatment Centers Northeast Inc | Clinic/Center | 657 Willow Grove St, West Wing Medical Plaza Ste 202, Hackettstown, NJ 07840-1713 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356963938 | Usrc Gloucester, LLC | Clinic/Center | 601 Berlin Cross Keys Rd, Sicklerville, NJ 08081-9563 | 2020-05-18 |
| 1679192876 | Knickerbocker Dialysis Inc | Clinic/Center | 1734 Hancock St, Ridgewood, NJ 11385-4734 | 2020-04-09 |
| 1750910295 | Elandon Dialysis LLC | Clinic/Center | 820 N Rte 17, Paramus, NJ 07652-3104 | 2020-04-06 |
| 1780212365 | Zellier Dialysis LLC | Clinic/Center | 1260 Route 22 E, North Plainfield, NJ 07060 | 2020-03-30 |
| 1437798386 | Total Renal Care Inc | Clinic/Center | 1800 State Route 34 Ste 302, Wall Township, NJ 07719-9146 | 2019-12-24 |
| 1598306276 | Fresenius Medical Care Passaic, LLC | Clinic/Center | 10 Clifton Blvd Ste 1, Clifton, NJ 07011-3802 | 2019-10-03 |
| 1821646035 | Isd Renal Inc | Clinic/Center | 262 Broad St, Newark, NJ 07104-3809 | 2019-08-30 |
| 1699323824 | Claymount Dialysis LLC | Clinic/Center | 21 Cornwell Dr, Bridgeton, NJ 08302-3632 | 2019-08-30 |
| 1962064758 | Fresenius Medical Care Bridgeton, LLC | Clinic/Center | 12 Cornwell Dr, Bridgeton, NJ 08302-3633 | 2019-07-02 |
| 1790347698 | Wellbound of Cherry Hill, LLC | Clinic/Center | 1945 Route 70 E Ste A, Cherry Hill, NJ 08003-2117 | 2019-07-01 |
| Find all providers with the same taxonomy | ||||
| City | HACKETTSTOWN |
| Zip Code | 07840 |
Please comment or provide details below to improve the information on PHYSICIANS DIALYSIS HACKETTSTOWN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.